急性中央颈脊髓损伤MRI表现及其与预后的关系

Magnetic resonance imaging of acute central cord syndrome: correlation with prognosis

目的 探讨急性中央颈脊髓损伤的MRI表现及其与预后的关系。方法 对 35例急性中央颈脊髓损伤的早期MRI检查资料进行分析 ,并与ASIA评分改善率进行比较。结果 非手术治疗组与手术治疗组ASIA评分改善率差异无显著性 (P >0 0 5 ) ,脊髓受压程度与改善率呈显著负相关 (P<0 0 1) ,脊髓信号无异常、脊髓水肿与脊髓血肿 3组病例的改善率差异有显著性 (P <0 0 1) ,脊髓血肿组预后最差。结论 MRI检查对选择治疗方法及判定预后具有指导意义 ,对于急性中央颈脊髓损伤不仅应常规行颈椎MRI检查 ,而且应尽早进行。

Objective To report magnetic resonance imaging(MRI) findings of acute central cervical cord syndrome and to determine their correlation with the prognosis. Methods MRI findings of 35 patients with acute central cord syndrome during the acute phase were studied and compared with the recovery rate of ASIA scoring. Results No significant difference of the recovery rate was found between the patients treated nonoperatively and operatively ( P >0 05). There was a significant inverse correlation between the recovery rate and the degree of spinal cord compression as shown in MRI scans ( P <0 01). The presence of hematoma in MRI scans was associated with poor prognosis, as demonstrated by a significant difference of the recovery rate ( P <0 01) among the patients with normal intensity, edema and hematoma within the spinal cord. Conclusion MRI scans provide efficient assistance for decision making and accurate prognostic information regarding neurological function, and therefore should be routinely performed within the early phase of acute central cord syndrome.